<%--
  Created by IntelliJ IDEA.
  User: HP
  Date: 2021/9/14
  Time: 23:38
  To change this template use File | Settings | File Templates.
--%>
<%@ page contentType="text/html;charset=UTF-8" language="java" %>
<html>
<head>
    <title>个人信息完善</title>

    <meta name="content-type" content="text/html; charset=UTF-8">

    <link rel="stylesheet" type="text/css" href="css/register.css">

    <script type="text/javascript" src="https://code.jquery.com/jquery-3.3.1.min.js"></script>
    <script type="text/javascript" src="js/My97DatePicker/WdatePicker.js"></script>
    <script type="text/javascript" >



        function myFunction(){
            alert("提交成功！");
        }

    </script>
</head>
<body>
<br>
<br>

<h2 style="margin-left: 15%">个人信息完善</h2>
<br>

<hr align=center width="70%" SIZE=3>
<br>
<br>

<center>
    <form action="patientServlet">
        <table>
            <tr><input type = "hidden" name = "operation" value="commitInfo"></tr>
            <tr> <td> 姓名：</td>
                <td style="width: 300px">
                    <label class="label1">
                        <input  type = "text" name = "comName" placeholder="请填身份证上姓名" class="input1">
                    </label>
                </td>
            </tr>
            <tr><td>&nbsp;</td></tr>
            <tr> <td> 性别：</td>
                <td style="width: 300px">
                    <label class="label1">
                        <input  type = "text" name = "comSex" placeholder="请填男/女" class="input1">
                    </label>
                </td>
            </tr>
            <tr><td>&nbsp;</td></tr>
            <tr> <td> 出生日期：</td>
                <td style="width: 300px">
                    <label class="label1">

                        <input type="text" name="comBornDate" placeholder="请选择出生日期" class="input1" onClick="WdatePicker({dateFmt:'yyyy-MM-dd HH:mm'})">

                    </label>
                </td>
            </tr>
            <tr><td>&nbsp;</td></tr>
            <tr> <td> 电话：</td>
                <td style="width: 300px">
                    <label class="label1">
                        <input  type = "text" name = "comPhone" placeholder="请填电话号码" class="input1">
                    </label>
                </td>
            </tr>
            <tr><td>&nbsp;</td></tr>
            <tr> <td> 年龄：</td>
                <td style="width: 300px">
                    <label class="label1">
                        <input  type = "text" name = "comIdentityId" placeholder="请填身份证号" class="input1">
                    </label>
                </td>
            </tr>
            <tr><td>&nbsp;</td></tr>
            <tr> <td> 医保卡号：</td>
                <td style="width: 300px">
                    <label class="label1">
                        <input  type = "text" name = "comMICN" placeholder="请填医保卡号码" class="input1">
                    </label>
                </td>
            </tr>

        </table>

        <input  type = "submit" value = "确定" class="sub" onclick="myFunction()">&nbsp;&nbsp;&nbsp;&nbsp;
        <a href="login.jsp"><input type="button" value="返回"  class="sub"></a>
    </form>
</center>


</body>
</html>
